Could someone tell me the best way to get rid of acne scars on my chin and my cheeks?
How to Get Rid of Acne Scars?
Doctor Answers (25)
Rid of acne scarring
Acne scars can be a very troubling problem. Even though the acne breakouts may be controlled or have long since stopped, the scarring remains for a lifetime.
Treatment for acne can be as troublesome as the disease itself. Usually, successful treatment requires a team approach with a dermatologist and a cosmetic surgeon.
First, attention must be turned to stopping any outbreaks, then repair of the scarring. If outbreaks continue, scarring is likely to continue, and any treatments aimed at treating scarring would be futile. There are many options for treatment of acne today depending on the severity of outbreaks. These are beyond the scope of this article, except to say that treatment for the underlying disease process is a must. Once the outbreaks are well controlled, attention can be turned toward erasing the lasting marks on the face.
Of note, acne is not only a disease of adolescence. Adult onset acne is not completely uncommon and is seen in women who are pregnant – often with more severe scarring. Treatment options for acne scars depend on the severity of the scarring and the skin type of the person wishing repair.
In people with darker skin, Fitzpatrick Types V, VI; options are limited because of concern for pigment irregularities after treatment. For lighter skinned individuals, treatments range from simple facial exfoliation to deep chemical or laser peels to surgical intervention.
For light scarring after acne, attention is placed on skin resurfacing. By taking off the outer layers of skin and stimulating collagen synthesis with new skin formation, acne scars can be reduced. This is best simulated by placing a finger on either side of an area of scarring and lightly pulling. If the scars fade, this can be a good option for resurfacing.
For deeper scars, a deep chemical peel, ablative laser (CO2 or erbium) resurfacing, or dermabrasion/dermasanding may be necessary. For deeper scars, deeper solutions are necessary. Again, several options exist.
- Deeper scars can be surgically excised with the larger acne scar replaced with a surgically placed small line. This can later be refined with other rejuvenation techniques.
- Punch grafting affords a simple method for treating multiple scars. A circular punch is used to create an incision around an acne scar. The scar is then allowed to heal and the resulting skin irregularity is smoothed.
- Subcision involves releasing the tethering attachments underneath the scar and then filling the space with either a temporary or permanent filler to prevent the scar from reforming when it heals. With the advent of new temporary artificial fillers such as hyaluronic acid, this is a good option for larger depressed scars.
Whatever the treatment option, it is important to consult a physician with a large arsenal of treatment options – if a physician only sells a cheeseburger, then you get sold a cheeseburger, even if you need a bacon burger. It is also important to remember that just as acne scars did not form overnight, treatment can sometimes take months to get the desired result. Once you find an experienced physician and decide on a treatment option, remember that it’s a long road but one that is usually worth the wait.
Treatment options for acne scars
There are many options for getting rid of acne scars including laser treatments. Depending on the type of scars you have, you may evaluate several or all of the following treatments:
- FULL CO2 laser resurfacing (very effective, long downtimes and high expense)
- Erbium Laser Resurfacing (Effective, several treatments and some downtime required)
- Fractional CO2 & Other (Effective, marginally less downtime than Erbium)
- Non-ablative laser treatments (less effective, more3 treatments and no downtime)
- Punch excision (effective for deep ice pick scars)
- Dermabrasion (effective for many scars, difficult recovery and long downtime)
- Subcision (effective for certain types of fibrous scars)
The bottom line is that the type of treatment depends on the type of scars and you should attend several consultations to get different ideas about your options. The cost, potential outcome and downtime are important factors in choosing the method. Try to find specialists in each of these procedures as no one physician will perform them all.
Best treatment for acne scars
First you must realize that not all scars are created equal. The best treatment depends on what type of scarring we are talking about!
I see a lot of DARK SPOTS in my practice. These can be treated with a combination of skin lightening products, attention to sunscreen, and microdermabrasion and or chemical peeling (if the acne is still very active). Also, it is foolish to concentrate on the scarring if the acne is not yet under good control. Its sort of like changing the carpeting in your house but your roof is still leaking.
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Getting rid of acne scars
There are generally three viable alternatives that we utilize on a regular basis:
- Erbium Laser which generally works with one treatment, but can be repeated if desired.
- Fraxel Laser which generally provides some improvement after 5 or 6 treatments.
- Injectables to fill the acne scars. This provides temporary but quick improvement of acne scars.
With any of these alternatives, you should find an experienced practitioner who is well trained.
Treating acne scars
Acne scars can be a devastating condition, and they have been notoriously difficult to treat. As noted by other physicians, they are almost impossible to remove completely, but we have many options to make the appearance of the scars much better.
There are different types of scars: some are shallow and gradual, some are deep - "ice-pick" scars - some are pigmented. Usually, it is the depth differential between the scar and surrounding skin that creates a light-shadow interface, and makes them prominent.
Most patients have a combination of different types, and are usually best treated by combination therapy. It can be a fairly long process for the patient, and may require patience on the part of both the patient and the physician.
Depending on type of the scar, our options are:
- Small shallow scars - usually can be addressed by a filler injection
- Deep ice-pick scars, especially large ones - need to be excised and meticulously reapproximated first, usually with subsequent dermabrasion or laser resurfacing.
- Dermabrasion has been a gold standard for treating extensive multiple scars. It is being gradually replaced by fractionated CO2 laser resurfacing. Among these, Deep FX is a promising new therapy for these patients. Sometimes several laser treatments are required, and occasionally dermabrasion followed by laser therapy is beneficial.
It is important to see a physician who has experience in treating these patients and who can offer you all of these options and recommend the right course of therapy.
Improving acne scars
While there is no way to make one’s skin that of a porcelain doll, acne scars can be improved. This usually requires a number of treatments with the CoolTouch, Smooth Beam, Affirm, Active FX or Fraxel lasers, which can minimize their appearance.
We often combine lasers with subcision and/or injection of fillers.
Acne Scar Treatment
The first step is to smooth out the canvas so to speak. The holes, pits and undulations that acne scarring can make are impossible to cover. Some solutions include:
- Excision on the scars works for the really deep and extensive scars. In this case the deep, wide scars are traded for surgical scars that are hopefully thin and flat but it depends a little on how you heal and location of the scar.
- Filling the scar with a filler and using subcision to get a
flat surface. Subcision is a technique
that helps to release the scar from below to help flatten it out. Filler is used as well. The long term fillers like Artefill are exceptional
for this and in fact Artefill is in the process of getting FDA approval for
this specific application.
- '"Sanding" the raised areas. This used to be accomplished with dermabrasion but today better results can be achieved with an ablative laser treatment.
I hope that helps.
Acne Scar Treatments
Acne Scar Treatment
The most effective treatment is our signature Focal Acne Scar Treatment (F.A.S.T.) procedure, which combines two different fractional CO2 lasers and delivers outstanding results in a short period of time. F.A.S.T. procedures remove acne scars and give patients’ their self-esteem back in record time. In addition you can do Fraxel laser therapy and fractional CO2 lasers. There is also the new platelet rich fibrin matrix (also known as PRP treatment or vampire facial), which promotes the growth of healthy skin and new collagen formation in and around the area of acne scars by introducing your body’s own growth factors deep into the dermis. This new acne star treatment is best used in combination with laser procedures and produces results that are very impressive.
Treatment for acne scars
One very common and frustrating type of scarring is the "rolling" or "pitted" scarring. Another common outcome of acne is post inflammatory hyperpigmentation, or brown discoloration left by the acne lesions.
Treatment options include:
Fraxel laser or other resurfacing laser
Subcision (releasing some of the bound down and scarred tissue from underneath the surface of the skin)
Punch grafting (surgically removing some deeper pitted scars)
Of course the most important treatment is to make sure your acne is under control in order to prevent future scarring.
I recommend that you consult with a local dermatologist or plastic surgeon to determine the best treatment plan for you.
Best of luck!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.